Do Artificial Sweeteners Promote Diabetes?

Artificial sweeteners like Splenda and Equal were once touted as a calorie counter’s best friends: You can drink all the sweet tea, lemonade, and soda you like, without ingesting a single calorie or gram of sugar. You can even eat pudding, ice cream, yogurt, baked goods, and other desserts sweetened with sugar-free substitutes. And yet, the proliferation of sugar-free foods and beverages doesn’t seem to have made a dent in the obesity epidemic.

I tackled this paradox in one of the very first Nutrition Diva episodes back in 2008. Back then, we still weren’t sure whether there was something about artificial sweeteners that directly promoted weight gain. Scientists wondered, for example, whether artificial sweeteners might backfire by causing cravings for other sweets or an increased appetite that would lead you to consume more calories. Early studies in rats seemed to support this theory, but results in human trials have been mixed.

This much is crystal clear: Artificial sweeteners do not automatically lead to weight loss or prevent weight gain.

Alternatively, it could have been more of a behavioral phenomenon. For example, it could be that using artificial sweeteners gives people a false sense of security that leads them to over-consume other foods. (The old “I’m having Diet Coke so super-size the fries” effect.)

This much is crystal clear: Artificial sweeteners do not automatically lead to weight loss or prevent weight gain. Among people who use artificial sweeteners, the only ones who seem to consistently lose or maintain their weight are the ones who also strictly monitor and restrict their intake of other foods.

How do artificial sweeteners affect blood sugar?

Another supposed advantage of artificial sweeteners is that they do not cause an increase in blood sugar the way sugar does. This would seem to have obvious benefits for those with diabetes or pre-diabetes. But a growing body of research suggests exactly the opposite.

Although the artificial sweeteners themselves don’t cause your blood sugar to rise, they appear to have a negative impact on your blood sugar response to other foods.

One large study found that consumption of aspartame (Equal) is associated with an impaired ability to manage glucose in those who are overweight.

Another study found that...

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